EMIS v7.1 Patient Access

Transcription

1 EMIS v7.1 Patient Access Patient Access is a web-based application which has been developed to expand the services available to patients from their GP Practice. It allows the patient to request services from their Practice online at a time convenient to them. HSCIC state that whenever a patient s ID is checked, the 91B Read code should be added. Current requirements on practices regarding online services: aim to have 20% of patients registered for at least one online service by end of March provide online access to clinical correspondence (i.e. Documents) from a chosen date (not later than 31/3/17) unless it may cause harm to the patient or contains reference to third parties. provide online access to CODED information - free text is optional (but recommended for Test Results). sensitive information may be hidden from the patient s view NB: For training, use dummy patient with dummy NHS number (e.g ). GP IT Training Team Berkshire Oxfordshire Buckinghamshire Wiltshire Gloucestershire NE Somerset Last updated: 26/10/2017

2 1. Activate and configure Access System Tools > EMAS Manager. Click Patient Facing Services in the Emis folder (which opens by default). If there is a red cross by the Patient Facing Services title, click Activate Application icon in the ribbon to change this to a green tick. NB: regardless of configuration, patients cannot access the system until they have been registered to do so. Changes can be made at any time General: (optional but recommended) Create a Welcome Message (displayed on the patient interface). Use for seasonal messages (e.g. flu) in addition to a general welcome/information. [Example: Welcome to the Your Practice Name online services. If you are over 65 years old, or have a long-term condition such as Diabetes or Chronic Heart Disease, don t forget to book in for your flu jab! ] 1.2. Services: Click the appropriate checkbox for the required services Appointments: (mandatory) Repeat prescriptions: (mandatory unless alternative available) Messaging: (not recommended) patients can send -like messages and the practice can reply. These messages will appear in the Patient Facing Services Messages section of the Tasks Workflow folder Demographics: (recommended) patients can inform the practice of changes to their address, phone number etc. This information will appear in the Patient Facing Services section of the Registration Workflow folder (Change Address Requests list) Pre-Registration: (recommended only if required) patients can provide their details in advance when they intend to register with you in the near future. It is used in practices with university students (and similar). The information provided will appear in the Patient Facing Services section of the Registration Workflow folder. NB: some further configuration is required to direct patients appropriately if you wish to use this option Online Registration: patients can request online to use online services and will be able to book a single appointment. The practice must accept these requests before the patient is enabled for all options (but patients can request access on numerous occasions without providing identification). The information provided will appear in the Patient Facing Services section of the Registration Workflow folder. Patients should be required to provide proof of their identity in person and this should be coded (91B).

3 1.3. Settings: Display clinician s gender/language: (gender option recommended; language not recommended unless the clinician wishes this to be advertised) patients can see the relevant data regarding the clinicians that have online appointments. [NB: To display Language/Gender for selected clinicians only, click Configure by Clinician then use checkboxes to specify for which clinicians the details will be displayed. To view current data recorded in the system (therefore visible if enabled) click Preview Settings on the Configure by Clinician dialog box. Click Save Changes if you amend the status of any of the checkbox(es).] 1.4. Appointments: Optional but recommended: create an Appointments message (displayed on the patient interface) to ensure patients know what limitations apply. [Example: For a doctor appointment, please click General Appointment. Asthma Review appointments should only be booked by patients who need an annual review. Please contact the surgery for nurse appointments. Please use the message box on the booking screen to give a short (just a few words) indication of the reason for this appointment. ] Select the desired number for Maximum booked appointments NB: includes appointments booked at practice, not just those booked online (recommendation: 3) Select the desired numbers for Book no sooner/later than (days) this determines the number of days before an appointment that it can be booked online. (NB: EMIS uses the following convention: Sooner = nearest time to the appointment, often 0 to include on the day; Later = latest time from the appointment, often 28 days) Use the pick list to set required option for Reason message (see above if you choose to use this option, to encourage patients to use it appropriately). This is the equivalent of asking for a Booking Reason. It may be Disabled, Optional or Mandatory (recommendation: Mandatory) Prescriptions: Optional but recommended: create a Prescribing warning message in the box of the same name (will be displayed on the patient interface) to ensure patients know what limitations apply. You could include instructions to mitigate any problems that arise. [Example: Please allow 48 hours before collecting your prescription or visiting your nominated pharmacy. Only repeat medications with remaining issues will be available to order online; contact the surgery for other medications. Do not use the message box to request an appointment; any such requests will not be processed. ] Use the pick list to set required option for Script request message (see above if you use this option to encourage patients to use it appropriately): Disabled, Optional or Mandatory (recommendation: Optional).

4 1.6. Record Access: Click the Use detailed coded record settings option button (Mandatory). Click the checkboxes to enable patients to view the relevant sections of their record. The minimum requirement at 31/03/17 was all coded data Laboratory test results (mandatory): it is optional but recommended to include free text (otherwise patients will only see Abnormal rather than the text chosen when a clinician files an incoming result). Click the Display free text from checkbox and set a date whereby filed text on/after that date will be visible to patients. If the checkbox is empty, NO free text will be visible Documents: click the Documents checkbox (now mandatory), but you may choose to click the Only show documents from checkbox and set a date (31/3/17 or earlier) whereby documents on/after that date will be visible to patients. If the date checkbox is empty, ALL documents will be visible. You may choose to click the Display free text from checkbox and set a date whereby free text attached to documents on/after that date will be visible to patients. If the checkbox is empty, NO free text will be visible Immunisations: (mandatory) to allow access to coded data Problems (mandatory): it is optional to include free text which was added to a coded Problem. Click the Display free text from checkbox and set a date whereby free text on/after that date will be visible to patients. If the checkbox is empty, NO free text will be visible Consultations: click the Consultations checkbox (mandatory) to allow access to coded data. You may click the Only show consultations from checkbox and set a date (31/3/17 or earlier) whereby consultations on/after that date will be visible to patients. If the checkbox is empty, ALL consultations will be visible. You may choose to click the Display free text from checkbox and set a date whereby free text included in a consultation on/after that date will be visible to patients. If the checkbox is empty, NO free text will be visible Messaging configuration settings: ONLY IF the practice has enabled Messaging (see 1.2.3), choose whether the incoming messages are sent to the Usual GP or to a specified User or Team. [Note: Usual GP is selected by default and cannot be removed even if the practice is not enabling Messaging. This default does not override the enabling of Messaging above.] 1.8. Save settings: Click Save Settings on the ribbon, then OK in the warning box that appears (you do not need to log out and back in to EMIS Web until after you have finished all the configuration).

5 2. Configure Clinicians Access Configuration > Organisation Configuration > Users folder. Find and select the required clinician. Edit User if not already open in edit mode and access the Role page. Use Patient Facing Services Booking pick list to determine which patients may book online appointments for this clinician: None clinician will not appear on Patient Access All Appointments any patient Own Patients Only - patients with this clinician as their Registered GP. Click OK to save then repeat this process for each clinician that is to have appointments available for online booking. 3. Configure Appointments From Appointment Book, click Appts Config to ensure that Show Patient Access Icon checkbox is enabled (in Your Slot Settings section, about ¾-way down). If not, click checkbox then click OK to save change Manual option Select one or more slots, right-click and choose Slot Properties. Click the Patient Facing Services checkbox on the Slot Properties dialog box then click OK. The online icon will appear alongside each amended slot. An ongoing task, but useful if extra slots are needed or need reclaiming from online availability. To reclaim slot(s), remove the tick from the Patient Facing Services checkbox on the Slot Properties dialog box then click OK. NB: it may be necessary to amend the Session templates and individual session headers for existing sessions if they were originally created with the Hide from Patient Facing Services option ticked! 3.2. Automatic options Access a Session Template (via Week Templates > New Session Template > Load from template) To make any number of specific slots available online every time that template is used in extending the books: right-click on the required slot(s) and choose Slot Properties. Click the Patient Facing Services Bookable checkbox then click Apply and Close To make all the slots available online every time that template is used: click All slots Patient Facing Services bookable Alternatively, click Hide from Patient Facing Services and Diary checkbox in a Session Template to ensure that none of the slots can be made available online.

6 3.3. Using online appointments An online appointment may still be booked in the practice, if required. However, the practice should set an appropriate policy; for example, do not use online appointments for patients booking in the practice unless the appointment is still available within 2 hours of the appointment time. If an online available appointment is booked online the online icon will remain; if it is booked in practice the icon will disappear. If a practice-booked online appointment is cancelled, the online icon will reappear. Log off and back on to EMIS for the configuration to take effect. 4. Register patient to use Patient Access Note: Proxy access (e.g. for parents, carers, those with Power of Attorney) will be enabled after all practices have version 7.1 of EMIS. Until then, you may choose to permit only patients aged 16 years or over to register for Patient Access (or use the code EMISNQCA1103 for carer access). In all cases, you should ensure that registration letters are only given to the specific patient or authorised carer in person. The patient should have completed the relevant document and provided photo ID which should not be copied or retained by the practice. If the patient has a verified, primary account recorded, then their PIN document can be ed to them Practice creates online account for patient NB: If a patient under 16 is being registered for access to their own record, it is necessary to add the competency code EMISNQCO278 (or EMISNQNO157 if not competent - when access will not be possible in their own right). Access the Registration screen for the required patient. Click tab 3. Patient Services under the patient precis bar. Click Add online user button then Add current patient. [When proxy access is enabled, there will be other choices at this point.] The Online user screen opens on the ID Verification page. Click Add and choose Personal vouching rather than Identity document (even if documentation is provided). Amend the user name in the Vouched by field to the person who has vouched, if not you. Enter appropriate text in the Additional information field (e.g. Passport seen, Patient known to me for 10 years, Vouched by questions). Click Save. Click Access in the left-hand panel. In the Linked patient section, the Relationship to patient field will default to Self-association until the proxy access facility is enabled.

7 In the Services section, click the relevant checkbox(es) to enable the features to be used by this specific patient. (Recommendation: Appointments, Repeat prescriptions, Demographics - these are all selected by default, but can be removed) In the Record access section, click the relevant option button to enable (Core or Detailed) or prevent (Disable) record viewing for this patient. NB: If Detailed access is requested, the record MUST be reviewed by a clinician before this access is granted - choose Core, then change to Detailed and ensure the relevant features are enabled, if the clinician gives approval (see end of section 5 on how/where to amend access levels). A patient may have less access than the global enablement, but not more. Click OK. Choose Print and give the document to the patient following proof of identity, or choose (or and Print) if appropriate. If an identity document was produced, code 91B into the patient record Patient creates login details Access the Patient Access website and click Register. Click Yes to confirm that letter has been received from the practice. Enter the details as required from the letter received and create a password. Set security questions so that a forgotten password could be sent via or text (where that data has been provided). Note: EMIS does not hold the patient s password. 5. Manage patient s online account Access the Registration screen for the required patient and click tab 3. Patient Services. On the right-hand side, click View online user link. Then click. Edit user to amend the patient s demographic details (e.g. mobile phone or address). [Note: this could also be done via Edit Patient Details.] Print PIN (or PIN or Print and PIN) for a copy of the PIN document. Reset account key if the patient has forgotten their password and security answers. Click Reset account key (on the screen that appears) to confirm. The patient s appointment and prescription history on their Patient Access account will be deleted, they will need to re-register and have their identity verified again to set up a new account as 4.2 above. Close account (e.g. no longer required or suspected illegitimate access). Choose the appropriate reason from the pick list. If the patient wishes to re-open the account, you will need to confirm their Identity verification again. Identity verification to add, edit or delete identity documents or vouching.

8 To amend the patient s level of access (by patient request or if patient is abusing the system): select the patient under the Linked patients pane at the bottom of the screen and click Edit online user access. [Note: when proxy access is enabled, all those with access to the patient s record will be listed here.] 6. Online registration to Patient Access (if enabled) NB: Patients using Online Registration can only book one appointment online and not use any of the other Patient Access features until they visit the practice with proof of identity and the practice accepts their account request Patient registers for online account Access the Patient Access website and click Register. Click No to confirm that no letter has been received from the practice. Enter practice or home postcode to identify your practice. Enter demographic details to create an account Practice processes Online Registration NB: This folder has been removed - ignore this section until further notice. A warning message will appear with the ability to Accept their online registration. Access Registration folder of Workflow Manager then Online Registration list in Patient Facing Services section. In the right-hand pane, click the required request to highlight it. If you have checked patient s identity click Accept Request (or Reject Request if you do not want the patient to be active for Patient Access). Note: If a patient who has registered online is marked as Arrived by reception for the appointment that they booked online before their registration has been accepted, a warning message is displayed regarding the check of their identity. The options available are: confirm identity and Accept the registration; Reject; Reject and Block the patient from using Patient Access; Postpone the registration and process through Workflow (as above) later. 7. Book online appointment (patient) 7.1. Book Appointment Any future appointments (booked at practice or online) are displayed. Click Book an appointment link to see all the available appointments. If required, use the filters (person, place, clinician gender and/or language if enabled) to reduce the listed appointments. Click the time link against the required appointment. Enter Reason for appointment (max 36 characters) then click Confirm. Options available to Save to Calendar (Outlook or icalendar) or to print.

9 The booked appointment will retain its online icon when booked online, but the icon is removed if the appointment is booked in the practice Cancel Appointment Click Cancel against existing appointment displayed. Select Reason from the pick list then Cancel Appointment to confirm. 8. Request Prescription Online (patient) 8.1. View available medication Click See your repeat prescriptions link to view any repeat medications that have remaining issues. Click Home link to return Request medication Click Request a repeat prescription link. Click checkbox next to each required option then click Request Selection. Enter an appropriate message (max 200 characters) if desired and available. Click Submit Request. Confirmation message is displayed (delivered or failed) Check status of Prescription Request Any requested drugs will be listed with the relevant Status: Requested: not yet processed by the practice Rejected: contact the practice if no reason has been given Accepted: request has been approved allow the requisite time before collecting from the surgery (or pharmacy if using electronic prescribing) 9. Process Online Prescription Requests (clinician) Medication requests from patients where there are no queries (requests) or with comments/queries (requests with queries) will appear in the two lists: Workflow > Medicine Management > Requests / Requests with queries The Source column will display Online (patient name). Select the required request in the top right-hand pane. Details, including any message from the patient, are displayed in the bottom right-hand pane. Click Open on the ribbon to display the Workflow Manager Task view. If desired/required deal with any clinical safety warnings that appear or click Override All on the ribbon to override the warnings, and then click Continue on the ribbon and/or type a message for the patient in the Patient Facing Services Message field at the bottom of the right-hand pane

10 Click Approve and Next on the ribbon (or Approve if there are no more requests in the list). When all (required) requests are processed click Issue Approved on the ribbon. The Workflow Manager Task screen will close, the repeat prescription request is removed from the Medicine Management folder and the scripts are printed or an electronic signature is requested. On the Patient Access website, Issued is displayed beside the medication item, together with any message, to notify the patient. 10. Process demographic updates (must use Smartcard) Access Registration folder of Workflow Manager then Change Address Requests list in Patient Facing Services section. In the right-hand pane, click the required request to highlight it. Details of the request are displayed in the lower right-hand pane. Check the details then click Accept Request (or Reject Request if desired). 11. Process a Patient Access message (if enabled) Access Tasks folder of Workflow Manager then Inbox list in the Patient Facing Services Messages section. In the right-hand pane, click the required message to highlight it. message content is displayed in the lower right-hand pane. Click Open Message in ribbon, type in Reply box then click Send. NB: The patient s message remains in the Inbox until you delete it. The 12. Reports In each case, it will probably be appropriate to set a Filter of Appointment Date (for the required date range) and a Format of Session Holders as Columns and Appointment Date as Rows with Table Options of Count and Include Totals Online Appointments (i.e. available via Patient Access): From Appointment Reporting, add a Filter of Slot Properties and select EMIS Bookable = True Slot Booking (booked via Patient Access): From Appointment Reporting, add a Filter of Slot Properties and select Booking Method = Patient Access. From Population Reporting, select Booking Method (Patient Access) as the Criteria for a report with Appointments as the Feature.

11 12.3. Online Appointments Used or DNA (booked online): From Appointment Reporting, add a Filter of Slot Properties and select DNA = Did Not Attend (or Attended) Patient Access (patients able to use Patient Access): Access Population Reporting and select Online User. The Criteria available allow searches on account status and the status of each of the relevant modules available in online access Medication: Search on Medication Requests under Medication Feature. Searchable fields are Request Date, Request Status and Request Source. Reportable fields are the searchable fields listed above, plus Rejection Reason, Request Query and Patient Access Query Response. 13. Pre-registration (if enabled) Patient submits details: Patients provide some registration details online which are held in EMIS until the patient attends to register in person. The patient must still complete and sign GMS1 (unless the CCG allows online registration), but details will be transferred from online registration. It requires a separate URL, which must be accurate usually via practice website ( The practice can offer separate URLs for UK and overseas patients (add &regtype=uk or &regtype=overseas at the end of the URL above) and can direct patients to a medical history questionnaire at the end of successful preregistration (add &quest-simple to end of URL). If online registration is permissible add &quest=register to end of URL. To return patient to practice website afterwards, add &returnurl= to end of URL Practice process the request: Access Workflow > Registration > Patient Facing Services > Pre-Registrations. Select the patient and click Complete Registration in the ribbon. The Add Patient screen is displayed, showing the details provided by the patient online. Ensure all remaining parts of the registration process are completed.